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Insurance Claims Manager (State Risk Adjuster 6)

Company: State of Louisiana
Location: Baton Rouge
Posted on: September 15, 2023

Job Description:

Salary : $4,470.00 - $8,767.00 Monthly

Location : Baton Rouge, LA

Job Type: Classified

Job Number: ORM 090823 ERG

Department: Division of Administration-Risk Management

Opening Date: 09/08/2023

Closing Date: 9/22/2023 11:59 PM Central

Supplemental Information
The Division of Administration/Office of Risk Management has a vacancy. This job title has an assigned pay grade of AS-619.

This vacancy will be filled by new hire or by promotion of a current permanent status classified employee.

A criminal history check may be conducted on all new hires as well as employees changing positions including promotions, demotions, details, reassignments and transfers. Also, prospective employees may be subject to pre-employment drug testing. New hires will be subject to employment eligibility verification via the federal government's E-verify system.

No Civil Service test score is required in order to be considered for this vacancy.

To apply for this vacancy, click on the "Apply" link above and complete an electronic application which can be used for this vacancy as well as future job opportunities. Applicants are responsible for checking the status of their application to determine where they are in the recruitment process. Further status message information is located under the information section of the Current Job Opportunities page.

Resumes WILL NOT be accepted in lieu of completed education and experience sections on your application. Applications may be rejected if incomplete.

Applicants qualifying based on college training or receipt of a baccalaureate degree will be required to submit an official college transcript to verify credentials claimed prior to appointment. Please make every effort to attach a copy of your transcript to your application. The transcripts can be added as an attachment to your online application or faxed to (225) 219-1041. The selected candidate will be required to submit original documentation upon hire.

For further information about this posting, please contact:

Erica R. Gay
HR Specialist
Division of Administration/Office of Human Resources


A baccalaureate degree plus four years of professional level experience in insurance claims adjusting, nursing, allied heath fields, construction management, or as a practicing attorney.

A master's degree in business or public administration, finance, accounting, statistics, insurance or risk management, safety or legal studies, nursing, allied health fields, or construction management will substitute for one year of the experience.

Experience in the fields of accident investigation, insurance claims examining, insurance claims investigation or insurance claims adjusting will substitute for the required college training on the basis of 30 semester hours for one year of experience.


This substitution allows any combination of experience and college hours to substitute for the baccalaureate degree. Thirty semester hours of college training is accepted as equivalent to one year of work experience, and college credit in increments of fewer than 30 hours is prorated on this basis.


Any college hours or degree must be from an accredited college or university.

Job Concepts
Function of Work:
To manage one of three claims sections of the multi-line property and casualty self-insurance program of the State.

Level of Work:

Supervision Received:
Administrative direction from the State Risk Administrator (Claims).

Supervision Exercised:
Direct line over State Risk Adjuster 5's.

Location of Work:
Division of Administration, Office of Risk Management.

Job Distinctions:
Differs from State Risk Adjuster 5 by responsibility for managing a section of claims adjustment units rather than a single unit within a section, and by a higher claim payment authority.

Differs from the State Risk Administrator (Underwriting and Loss Prevention) by the absence of responsibility for the comprehensive risk program.

Differs from the State Risk Administrator (Claims) by the absence of full authority for the claims adjustment division, and by unlimited claims payment authority and unlimited authority when participating as a member of the Claims Council.
Examples of Work
The State Risk Adjuster 6 is a manager position, directly supervising subordinate State Risk 5 Adjuster (Supervisors) positions. Performs personnel supervision and administration. Uses good communication, documentation, observation, and assessment skills to fairly plan and accurately evaluate the performance of each employee supervised. Develops professional growth and/or improvement plans for unit personnel.

Responsible for program management, directing and consulting with direct reports who are the first line supervisors to oversee, monitor and review the work of the State's Third Party Administrator's (TPA) desk examiners and claim adjusters in responding to self-insured claims and insured commercial claims. Supervisors ensure claims are efficiently handled in accordance with the Risk Management Program's insurance policies; state laws and regulations; administrative policies and rules; and ORM procedures, guidelines, goals and directives. Develops and maintains desk references with procedures and practices to be followed by the Supervisors and client instructions that relate to claim handling by the TPA staff.

The position has functional management over the TPA's claims handling activities relating to General Liability coverage which includes Premise Liability, Errors and Omissions, False Arrest, Civil and Constitutional Rights, etc. The Manager serves as the primary assistant to the State Risk Administrator for Casualty Claims, in relation to all claim services, duties and responsibilities associated with the assigned lines of insurance. The position reports to and receives administrative direction from the Administrator.

Reviews, responds to inquiries and manages problems relating to coverage questions; reserves; catastrophic losses; investigations of cause and extent of loss; and other claims related issues. Investigates, troubleshoots, proposes solutions and leads in resolution of serious problems impacting claims management. Reviews catastrophic claim files with Supervisors and the Administrator to develop strategies and offer suggestions and advice for further TPA handling and claim management. Reviews and make decisions on complex coverage issues. Maintains reports on high profile claims. Responsible for ensuring that the TPA complies with contract terms. Exercises contract management oversight, utilizing performance standards and guidelines in evaluating claim files and conducting performance reviews of the TPA and its employees.

Particular emphasis is placed on monitoring/auditing activities of the TPA relative to payments in excess of $25,000 and reserves in excess of $250,000. Maintains written claim monitoring and performance management plans. Ensures that the TPA provides the specified levels of service they are contracted to carry out and represent the State of Louisiana's best interests in the work they perform. Participates in meetings with TPA's executives and high-ranking members of management, to present information and discuss service challenges. Accountable for completeness and accuracy of established reserves on claims. Reviews cases in excess of $1,000,000 for financial impact and verification of involvement with the State's excess carrier and to ensure the TPA seeks recovery of expenditures over the State's retention level when applicable.

Serves as a voting member of claims council along with the Administrator and the Assistant Director for Litigation Management, which authorizes trial authority and/or settlement authority, etc. up to $5,000,000 contingent upon additional approval from the Commissioner of Administration, the Attorney General, and the Litigation Subcommittee of the Joint Legislative Committee on the Budget when funding is $500,000 or above. Authorizes payments up to $200,000 and authority to increase reserves up to $1,000,000 without additional approvals. Possesses direct authority on subrogation files to waive up to 50% of the total recoverable lien amount in exchange for a full and final release of the claim.

Performs the functions involved in costs and system analysis, dissemination of information and budget and resource development for the management of the business unit. Reviews proposed legislation for fiscal impact on ORM as well as the State. Performs any and all other duties as assigned.

Louisiana State Government represents a wide variety of career options and offers an outstanding opportunity to make a difference through public service. With an array of career opportunities in every major metropolitan center and in many rural areas, state employment provides an outstanding option to begin or continue your career.

As a state employee, you will earn competitive pay, choose from a variety of benefits, and have access to a great professional development program:

Insurance Coverage More information can be found at

Holidays and Leave - State employees receive the following paid holidays each year:

  • New Year's Day
  • Martin Luther King, Jr. Day,
  • Mardi Gras,
  • Good Friday,
  • Memorial Day,
  • Independence Day,
  • Labor Day,
  • Veteran's Day,
  • Thanksgiving Day and Christmas Day.
    ***** Additional holidays may be proclaimed by the Governor

    State employees earn sick and annual leave which can be accumulated and saved for future use. Your accrual rate increases as your years of service increase.

    Retirement- State of Louisiana employees are eligible to participate in various retirement systems (based on the type of appointment and agency for which an employee works). These retirement systems provide retirement allowances and other benefits for state officers and employees and their beneficiaries. State retirement systems may include (but are not limited to):
    • Louisiana State Employees Retirement System (). LASERS has provided this video to give you more detailed information about their system
    • Teacher's Retirement System of Louisiana (),
    • Louisiana School Employees Retirement System (), among others


      Do you possess any managerial experience? If so, provide information as to how many employees have you supervised and explain to what degree?


      How do you deal with conflict in the workplace?


      Do you work well on a team? How would you define teamwork?


      Do you have experience supervising and/or authorizing insurance claims adjusting services provided by contract personnel employed by a Third Party Administrator? If yes, provide details of your role and responsibilities.


      Do you have any experience reviewing and evaluating tort liability insurance cases involving litigation? If yes, describe your overall experience and specifically address tort liability litigation areas relating to inmates/prisoners, ADA, and/or violation of civil rights.


      Describe prior experience overseeing litigation management, including reviewing and authorizing tort liability litigation defense budgets and/or requests for settlement authority.


      Are you familiar with reservation of rights letters? If yes, describe your experience in the preparation or processing of such.


      Describe any experience in reviewing lawsuits to evaluate for insurance coverage, including defense and indemnification.


      Describe your experience, training and skill level using Microsoft Excel and Word.

      Required Question

Keywords: State of Louisiana, Baton Rouge , Insurance Claims Manager (State Risk Adjuster 6), Executive , Baton Rouge, Louisiana

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